Clinical Question: How does Neffy (epinephrine nasal spray) compare to the Epinephrine autoinjectors?
Joanne Routsolias, PharmD
Read MorePharm & Cheese: Asymptomatic Hyperglycemia
Imagine. You're on a busy red team shift. A clinic calls to send a patient with asymptomatic hyperglycemia to the ED. You roll your eyes, transfer it to the attending. The patient of course lands in the resus bay and you go to evaluate them. Their sugar is 450 mg/dL, they have no symptoms and their vitals are normal. You mindlessly order a VBG, basic labs and a liter of fluid and move on with your day. However, is this all necessary? What should our end goal be? What should I choose as my intervention if necessary? Do I even need labs?
Kathryn McGregor MD, Joanne Routsolias PharmD, and Eric Leser MD
Read MorePharm & Cheese: ⚡ Thyroid Storm 🌩
There are no specific lab value parameters that differentiate thyroid storm from less severe thyrotoxicosis, but the presence of multiorgan dysfunction is key8. We have a great guideline for general thyrotoxicosis management (“Thyrotox Updated Guideline”) on the Intranet, so this Cheese is only a closer look at thyroid storm in particular.
Nanditha Ravichandran MD, Joanne Routsolias PharmD, and Eric Leser MD
Read More